Eye Inflammation: Causes, Symptoms, and Treatment Options

Conjunctivitis, Scleritis, Keratitis

Several months ago, the patient sustained an eye injury while showering at night.
The following day, due to a holiday, they could only visit the emergency department.
The doctor examined the eye and stated that there was no visible corneal damage, but the patient experienced some pain, a foreign body sensation, tearing, and photophobia.
The doctor diagnosed it as an eye inflammation and prescribed chloramphenicol eye drops and ointment.

Upon visiting an ophthalmologist later, the doctor noted damage to the sclera and prescribed antibiotic eye drops and ointment for a month, after which the wound healed.
However, a few days after stopping the medication, the patient experienced a recurrence of inflammation, with redness, swelling, severe pain, and increased sensitivity to light, necessitating another emergency visit.
The doctor prescribed tobramycin eye drops, which provided some improvement, but two days later, the patient developed a new symptom: every time they blinked, it felt like eyelashes were scratching their eye, causing significant pain.

A subsequent visit to the ophthalmologist resulted in a diagnosis of conjunctivitis and keratitis.
After two weeks of treatment, the pain and photophobia subsided, but two new blood vessels appeared on the sclera.
Less than a week later, the condition relapsed, with the blood vessels becoming red and painful again, accompanied by photophobia.
The patient reapplied tobramycin, but it was less effective than before.
They also took anti-inflammatory medication, which controlled the inflammation and reduced the redness.
However, they noticed a small red area near the cornea, which was raised and elastic to the touch but painless, suggesting a fluid-filled area.
During a follow-up with the ophthalmologist, the doctor diagnosed scleral inflammation.
The patient requested anti-inflammatory medication and stopped using eye drops.
After two weeks of anti-inflammatory treatment, the inflammation resolved.
The patient has several questions for the doctor:
1.
Is the eye inflammation related to the prolonged use of antibiotic medications?
2.
Why does scleral inflammation cause a raised area on the sclera?
3.
I used benzalkonium chloride continuously for over two months without wearing contact lenses.
Could it be absorbed by the cornea, and what impact could it have on the cornea?
4.
When I initially injured my eye, it felt like shampoo had gotten into it, and after rinsing, there was some discomfort and a stinging sensation when moving my eye.
If the cornea was scratched, wouldn’t any contact with water cause more pain, regardless of the size of the corneal injury?
5.
Given the severity of the eye inflammation and its recurrent nature, will there be any long-term consequences after healing?
I hope the doctor can patiently address these questions.
Thank you!

carol, 30~39 year old female. Ask Date: 2016/07/24

Dr. He Jianxian reply Ophthalmology

Since I have not actually seen your condition, I cannot provide an answer to your question.
Generally, corneal injuries and the use of antibiotic eye drops should not lead to subsequent complications such as scleritis.
As for whether you will have any sequelae after recovery, I cannot comment without having assessed your condition.

Reply Date: 2016/07/24

More Info

Eye inflammation, also known as ocular inflammation, can arise from various causes, including injuries, infections, allergies, and underlying medical conditions. The symptoms you described, such as pain, redness, tearing, and light sensitivity, are common indicators of inflammation in the eye. Your experience with recurrent inflammation following an initial injury highlights the complexity of ocular health and the potential for complications.

1. Antibiotic Use and Inflammation: Prolonged use of antibiotic eye drops, such as chloramphenicol and tobramycin, can sometimes lead to complications, including resistance to the medication or disruption of the natural flora of the eye. However, it is unlikely that the duration of antibiotic use directly caused your recurrent inflammation. Instead, the initial injury may have led to a cascade of inflammatory responses, making the eye more susceptible to further irritation or infection. It is essential to follow your doctor's advice regarding the duration of antibiotic treatment and to report any persistent symptoms.

2. Pterygium and Inflammation: The swelling you observed in the white part of your eye (sclera) could be related to a condition known as pterygium or a form of scleral inflammation. Pterygium is characterized by the growth of tissue on the conjunctiva that can extend onto the cornea, often associated with UV exposure, irritation, or inflammation. The presence of blood vessels indicates increased vascularization due to inflammation. The elastic, painless bump you described may suggest a fluid-filled cyst or a benign growth. It is crucial to have this evaluated by an ophthalmologist to determine the appropriate treatment.

3. Benzalkonium Chloride and Corneal Absorption: Benzalkonium chloride (BAK) is a common preservative in many eye drops. Prolonged exposure can lead to toxicity in the corneal epithelium, especially if used without breaks or in high concentrations. While you mentioned not wearing contact lenses, which is good practice during treatment, it is still essential to monitor for any signs of corneal damage. If you experience persistent discomfort or changes in vision, consult your eye care provider.

4. Pain and Water Exposure: When you rinsed your eye with water after the injury, if there was a corneal abrasion, it could indeed cause increased pain. The cornea is highly sensitive, and any disruption can lead to significant discomfort, especially when exposed to water or other irritants. It is essential to avoid self-treatment and seek professional care for eye injuries to prevent complications.

5. Long-term Effects of Inflammation: Recurrent inflammation can lead to scarring or changes in the cornea and conjunctiva, potentially affecting vision. While many individuals recover without long-term issues, some may experience persistent symptoms or complications. Regular follow-ups with your ophthalmologist are crucial to monitor your condition and address any emerging concerns.

In summary, managing eye inflammation requires a comprehensive approach, including proper diagnosis, treatment, and monitoring. If you experience recurrent symptoms, it is vital to communicate with your healthcare provider to adjust your treatment plan accordingly. Additionally, practicing good eye hygiene, avoiding irritants, and protecting your eyes from UV exposure can help prevent future episodes of inflammation. Always consult with an eye care professional for personalized advice and treatment options tailored to your specific situation.

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